NHS Scotland has funded more than 1,500 gender reassignments in the past decade, figures show.
It approved 594 genital surgeries, including 424 male to female ops at £10,737 each.
The 170 female to male procedures were £20,750 a time.
NHS Scotland also sanctioned 907 chest reconstructions at a standard cost of £5,804.
Its total spending on gender reassignment operations between 2014/15 and 2023/24 topped £13million.
Most funding was for the 18-25 and 26-39 age groups.